November 20th, 2010 by KevinMD in Better Health Network, Health Policy, News, Research
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Hospitals have recently been stepping up their infection control procedures, in the wake of news about iatrogenic infections afflicting patients when they are admitted. Doctors are increasingly wearing a variety of protective garb — gowns, gloves, and masks — while seeing patients.
In an interesting New York Times column, Pauline Chen wonders how this affects the doctor-patient relationship. She cites a study from the Annals of Family Medicine, which concluded that,
fear of contagion among physicians, studies have shown, can compromise the quality of care delivered. When compared with patients not in isolation, those individuals on contact precautions have fewer interactions with clinicians, more delays in care, decreased satisfaction and greater incidences of depression and anxiety. These differences translate into more noninfectious complications like falls and pressure ulcers and an increase of as much at 100 percent in the overall incidence of adverse events.
Hospitals are in a no-win situation here. On one hand, they have to do all they can to minimize the risk of healthcare-acquired infections, but on the other, doctors need to strive for a closer bond with patients — which protective garb sometimes can impede. Read more »
*This blog post was originally published at KevinMD.com*
November 7th, 2010 by John Mandrola, M.D. in Better Health Network, Health Policy, News, Opinion, Research
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I don’t consider myself a right-wing healthcare fear monger, but if I were this study would be worthy of amplification. As reported concisely in the New York Times, from the journal Demography (not previously known to me), population researchers reported that even though elderly Americans have more medical problems than their peers in Britain, older Americans live longer once they make it to 70. Why would this be?
Is it because Americans who reach 70 are “heartier” than Britons, as Columbia University PhD (but now on leave and working at HHS) Sherry Giled says. Or is better survival of the American elderly one of the benefits of the “fury of American medicine?” Read more »
*This blog post was originally published at Dr John M*
October 5th, 2010 by GarySchwitzer in Better Health Network, Health Policy, Health Tips, News, Opinion, Research, Video
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We reviewed four stories on the Swedish mammography study that appeared in the journal Cancer last week. Three of the four stories gave a pretty clear indication that there were methodological concerns about the Swedish research (of the four reviewed, only HealthDay offered no such hint):
• 4th paragraph of AP story: “The new study has major limitations and cannot account for possibly big differences in the groups of women it compares.”
• 1st paragraph of LA Times blog story: “Critics charged that the study was poorly designed and potentially vastly misleading.”
• 2nd sentence of NY Times story: “Results were greeted with skepticism by some experts who say they may have overestimated the benefit.”
But none of the stories did a very complete job of explaining those potential limitations. Because of the confusion that must be occurring in the minds of women — especially those in their 40s — this is a time in which journalism must rise to the need and do a better job of evaluating evidence and helping readers make sense of what appear to be conflicting findings.
I was in Chapel Hill, North Carolina, when the study was published and had the chance to talk about it with former U.S. Preventive Services Task Force member, and a recognized thought leader on issues of prevention and especially of screening tests, Dr. Russell Harris, Professor and Director of the Health Care and Prevention Concentration of the University of North Carolina (UNC) School of Public Health. Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
October 5th, 2010 by Davis Liu, M.D. in Better Health Network, Health Tips, News, Opinion, Research
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The New York Times recently ran a piece that wondered if doctors were treating patients with cholesterol-lowering medication unnecessarily because a web-based calculator over estimated a person’s risk. The program was proudly sponsored by the pharmaceutical roundtable and was available at the American Heart Association.
The implication was obvious. Simple tool determines an individual’s risk for heart attack or death from heart attack. It over estimates risk. Patients treated unnecessarily. To be also clear, the program did underestimate risk as well.
Unfortunately, the article missed an important point. While the simplified calculator may not be as accurate as the more complex algorithm used by the National Cholesterol Education Program, the truth is doctors are likely to be overtreating patients not because the former program is presented by the pharmaceutical roundtable, but for another reason. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
October 1st, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion
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The average medical school debt today, according to the Association of American Medical Colleges, is $156,456.
The United States is the only country in the world were future doctors have to bear such a financial burden of their education. That places significant strain on any relationship involving an American medical student.
Recently, there was an interesting piece in the New York Times discussing this very issue. The article profiled a female medical student who had amassed $250,000 of school debt:
Still, if she and [her boyfriend] Mr. Kogler are going to move in together and get engaged, she wants their financial arrangements to be clear and fair. But how do you define fair when you’re bringing a quarter of a million dollars in debt to a relationship?
Indeed. It’s an issue that’s rarely discussed, yet frequently encountered by medical students. With that degree of debt, there is little room for flexibility should one’s future plans change. You have to continue working to pay off the loan. Read more »
*This blog post was originally published at KevinMD.com*
